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Objective We analyzed application and match rates for pain medicine training in the United States and hypothesized that there would be (1) greater growth in the number of training positions than applicants, (2) higher match rates among US allopathic graduates relative to non-US allopathic graduates, and (3) greater number of unfilled training positions over time. Design Retrospective, cross-sectional study of all applicants for pain medicine training in the United States. Method National Resident Matching Program data were obtained over a ten-year period (2014-2023). Match rates and applicant-to-position ratios were calculated and compared over time with linear regression. Comparisons were made with chi-square tests. Results Growth in the number of annual training positions (261-377, 44% increase) exceeded growth in the number of interested applicants (398-415, 4% increase) (P  < .001). Annual applicant-to-training position ratios decreased (1.5-1.1, P  < .001). The representation of US allopathic graduates among incoming pain medicine fellows decreased over the study period (73%-58%, P  < .001) while US osteopathic graduates increased (9%-28%, P  < .001). Match rates increased for both US allopathic graduates (71%-91%, P  < .001) and non-US allopathic graduates (51%-81%, P  < .001). From 2018 to 2023, US allopathic graduates (79%) had higher match rates than US osteopathic graduates (60%, P  < .001) and international medical graduates (57%, P  < .001). More available annual training positions went unfilled over the study period (2%-5%, P  = .006). Conclusions Stagnant annual applicant volume and increasing number of available training positions have led to increasing match rates for pain medicine fellowship training. Fewer US allopathic graduates are pursuing pain medicine training. The increasing percentage of unfilled training positions warrants ongoing surveillance. [ABSTRACT FROM AUTHOR]

Pollen reconstructions of tree genera in North America since glaciation are available, but species distributions predicted for paleoclimate based on tree inventories may inform knowledge gaps. Here I examined the distributions of 25 species or species groups from 20 000 years ago (ka) to 5 ka to give potential paleoecological ranges of boreal and temperate tree species. I also assessed the effects of correlated climate variables on species distribution models for current and past climate, which were modeled with the non‐linear random forests classifier. Climate change alone was enough to create unique, species‐specific paths that did not run directly north. At 20 ka, black spruce (Picea mariana) occurred as far north as the ice sheet and most boreal species generally may have extended as far south as 32°N, or the northern southeastern United States. Temperate eastern species may have extended as far north as 39°N in low‐elevation locations and temperate eastern species displayed both continuous and clustered distributions across the southeastern United States. Rate of movement was 5.5 km per century between 20 and 14 ka, 13.3 km per century between 14 and 10 ka, and 3.25 km per century between 10 and 5 ka. Species retreated southward between 7 and 5 ka. Regarding correlation, models with all variables had greater accuracy than models with the two most important variables, which had greater accuracy than models with two variables of intermediate importance, demonstrating both reduced accuracy with omission of relevant variables and isolation of important variables that improve accuracy in models with correlated climate variables. Models from different climates identified the same two most important variables and ranked the remaining variables similarly, revealing robustness in the models over time. Distribution models agreed with pollen reconstructions regarding timing and rate of change, while generating detailed species‐specific information about movement trajectories and velocities, latitudinal extents, and distribution continuities. [ABSTRACT FROM AUTHOR]

This paper extends the buffered autoregressive model to the buffered vector error-correction model (VECM). Least squares estimation and a reduced-rank estimation are discussed, and the consistency of the estimators on the delay parameter and threshold parameters is derived. We also propose a supWald test for the presence of buffer-type threshold effect. Under the null hypothesis of no threshold, the supWald test statistic converges to a function of Gaussian process. A bootstrap method is proposed to obtain the p-value for the supWald test. We investigate the effectiveness of our methods by simulation studies. We apply our model to study the monthly Federal bond rates of United States. We find the evidences of buffering regimes and the asymmetric error-correction effect. [ABSTRACT FROM AUTHOR]

Background Recent studies have suggested that Kaposi sarcoma (KS) rates might be increasing in some racial/ethnic groups, age groups, and US regions. We estimated recent US trends in KS incidence among people living with human immunodeficiency virus (HIV; PLWH). Methods Incident KS patients aged 20–59 years were obtained from 36 cancer registries and assumed to be living with HIV. The number of PLWH was obtained from national HIV surveillance data from 2008 to 2016. Age-standardized KS rates and annual percent changes (APCs) in rates were estimated by age, sex, race/ethnicity, state, and region. Results Between 2008 and 2016, the age-adjusted KS rate among PLWH was 116/100 000. Rates were higher among males, in younger age groups, and among white PLWH. Washington, Maine, and California had the highest KS rates among PLWH. KS rates among PLWH decreased significantly (average APC = −3.2% per year, P  < .001) from 136/100 000 to 97/100 000 between 2008 and 2016. There were no statistically significant increases in KS rates in any age, sex, or racial/ethnic group or in any geographic region or state. However, there were nondecreasing trends in some states and in younger age groups, primarily among black PLWH. Conclusions KS incidence rates among PLWH have decreased nationally between 2008 and 2016. Though there were no statistically significant increases in KS rates in any demographic or geographic group, nondecreasing/stagnant KS trends in some states and among younger and black PLWH highlight the need for early diagnosis and treatment of HIV infection. [ABSTRACT FROM AUTHOR]

This paper examines the impact of internet information on COVID-19 vaccination rates across U.S. states. Does greater information on the internet about COVID-19 vaccine access increase the number of vaccines administered? Does greater information about COVID-19 vaccine reliability facilitate vaccine administration? To gauge the COVID-19 related information on the world-wide-web we created two cross-state datasets using Google search. One search dealt with searching for information on vaccination availability and scheduling in each state, while the other search involved information on vaccine reliability and its side effects. The estimation results showed that greater availability of the relevant information on the internet increased vaccine administration rates, and this was true for both types of internet searches, resulting in an affirmative answer to the questions above. In contrast, the diffusion of internet access and the digital divide across states did not have a significant impact on vaccination rates. Whereas supply chain issues have garnered most of the attention in terms of the limitations of quickly vaccinating the public, our results show that internet information might be acting as a (largely unheralded) enabler. [ABSTRACT FROM AUTHOR]

The United States has ceded to the rest of the world managing the dollar's value. For a generation, the U.S. authorities have all but withdrawn from the foreign exchange market. Yet the dollar does not float freely as a result of this hands-off U.S. policy. Instead, other authorities manage the dollar exchange rates, albeit separately. These authorities make heavier purchases of dollars in its downswings than in the upswings, damping its decline. Thus, the Fed finds that accommodative monetary policy transmits less to U.S. manufacturing and traded services, and relies on still lower rates to stimulate interest-sensitive housing and auto demand. The current U.S. dollar policy of naming and shaming surplus-running countries accumulating foreign exchange reserves does not seem to work. Three alternatives warrant consideration. First, the U.S. could reinstate its withholding tax on interest income received by non-residents and even add policy criteria to bilateral tax treaties. Second, the U.S. authorities could retaliate by selling dollars against the currencies of dollar-buying jurisdictions running chronic surpluses. However, either the withholding tax or such retaliatory foreign exchange intervention pose huge practical challenges. Third, the U.S. authorities could re-enter the foreign exchange market, making large-scale asset purchases in foreign currency when the dollar rises sharply against its average value. Such a policy would encourage private investment in U.S. traded goods and service production. The challenge is to set ex ante foreign exchange intervention rules to guide market participants' expectations, even positioning them to do the authorities' work. [ABSTRACT FROM AUTHOR]

We investigate the consistency under inversion of jump diffusion processes in the foreign exchange market. That is, if the EUR/USD exchange rate follows a given type of dynamics, under which conditions will USD/EUR follow the same type of dynamics? After giving a numerical description of this property, we establish a suitable local volatility structure ensuring consistency. We subsequently introduce jumps and analyze both constant and random jump size. While in the first scenario consistency is automatically satisfied, the second case is more involved. A fairly general class of admissible densities for the jump size in the domestic measure is determined. [ABSTRACT FROM AUTHOR]

Bats are found as fatalities at most wind energy facilities around the world, creating a challenge for wind developers to predict risk to bats in an area before building a new facility. Bat echolocation activity surveys are the standard method for assessing risk, but their effectiveness has not been demonstrated. Sites with relatively low pre-construction bat activity rates are predicted to yield relatively low post-construction fatality rates (i.e., low risk), and vice-versa. To test this hypothesis, we ran simple linear regressions on bat activity rates and fatality rates from 49 paired pre- and post-construction studies across the United States and Canada. Bat activity rates did not predict bat fatality rates at wind energy facilities by detector height, by call frequency category of bats, or by season (P > 0.10). One possible explanation for the lack of a predictive relationship is that bat activity patterns may change between the pre- and post-construction periods if bats are attracted to turbines. Indeed, we found support that bat activity rates increased across call frequency category and season at four wind facilities that had measured bat activity rates before (x̄ = 1.89 bat passes/detector-night) and after turbines were built (x̄ = 4.84 bat passes/detector-night). However, simple linear regressions of post-construction activity rates and fatality rates from 25 studies found no correlation between activity and fatality rates collected concurrently by detector height (ground, raised, nacelle) or by call frequency category (P > 0.05). We conclude that the current pre-construction survey methods of collecting bat activity rates at proposed wind energy facilities do not provide reliable information on how many bat fatalities there may be once the facility is built, and advocate exploring other methods for assessing risk to bats prior to wind development. [ABSTRACT FROM AUTHOR]

Background: The current U.S. orthopaedic residency application process is becoming increasingly impersonal in the wake of an increasing number of applications. Through an analysis of orthopaedic surgery residency application statistics, we have highlighted the effect that the number of orthopaedic applications has on match rate, and we have suggested methods for a more personalized application process.Methods: Data from the Association of American Medical Colleges (AAMC) and the National Resident Matching Program (NRMP) for United States orthopaedic residency applicants from 2008 to 2018 were collected. These data included the average number of applications submitted per applicant, the average number of applications received per program, the total number of residency positions offered in the U.S., the total number of U.S. applicants, and the total number of U.S. applicants who matched to a U.S. orthopaedic surgery residency program. U.S. applicant match rates and the average number of applications received per residency position offered were calculated. Linear regression models were used to determine the rate at which these variables changed over time.Results: The average number of applications submitted by an applicant increased from 46.5 in 2008 to 74.9 in 2018. The average number of applications received per residency position offered increased from 54.1 in 2008 to 85.7 in 2018. The number of U.S. applicants was 740 in 2008 and 849 in 2018. The number of U.S. orthopaedic residency programs only slightly increased from 160 in 2008 to 171 in 2018. The match rate for U.S. medical school applicants has remained stable from 2008 to 2018 at a mean of 76.9% and a standard deviation of 2.3%.Conclusions: The match rate has remained stable from 2008 to 2018 despite an increase in the number of applications per position. This discrepancy suggests that increasing the number of submitted applications may not correlate with applicant success. We address this discrepancy and suggest methods that can potentially allow for a more targeted orthopaedic application experience. [ABSTRACT FROM AUTHOR]

The US Centers for Disease Control and Prevention recommends screening populations at increased risk for tuberculosis (TB), including persons born in countries with high TB rates. This approach assumes that TB risk for expatriates living in the United States is representative of TB risk in their countries of birth. We compared US TB rates by country of birth with corresponding country rates by calculating incidence rate ratios (IRRs) (World Health Organization rate/US rate). The median IRR was 5.4. The median IRR was 0.5 for persons who received a TB diagnosis <1 year after US entry, 4.9 at 1 to <10 years, and 10.0 at >10 years. Our analysis suggests that World Health Organization TB rates are not representative of TB risk among expatriates in the United States and that TB testing prioritization in the United States might better be based on US rates by country of birth and years in the United States. [ABSTRACT FROM AUTHOR]

The US Centers for Disease Control and Prevention recommends screening populations at increased risk for tuberculosis (TB), including persons born in countries with high TB rates. This approach assumes that TB risk for expatriates living in the United States is representative of TB risk in their countries of birth. We compared US TB rates by country of birth with corresponding country rates by calculating incidence rate ratios (IRRs) (World Health Organization rate/US rate). The median IRR was 5.4. The median IRR was 0.5 for persons who received a TB diagnosis <1 year after US entry, 4.9 at 1 to <10 years, and 10.0 at >10 years. Our analysis suggests that World Health Organization TB rates are not representative of TB risk among expatriates in the United States and that TB testing prioritization in the United States might better be based on US rates by country of birth and years in the United States. [ABSTRACT FROM AUTHOR]

Gray seals were historically distributed along the northeastern coast of the United States, but bounties and lack of protection reduced numbers and they were rarely observed for most of the 20th century. Once protections were enacted, the population started to rebound. Here, we describe the recolonization and recovery of gray seals in the United States, focusing on the re-establishment of pupping sites. We fit individual generalized linear models to various time series (1988–2019) to estimate rates of increase in observed pup counts at four of the more data-rich sites. Annual rate of increase at individual sites ranged from −0.2% (95% CI : −2.3–1.9%) to 26.3% (95% CI : 21.6–31.4%). The increase in sites and number of pups born in the United States is driven by population growth and immigration from Canadian colonies and is part of a larger recovery of the Northwest Atlantic population. Wildlife protection, a healthy source population, habitat availability, and species traits that allow for dispersal and high productivity were all important factors in this recovery. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to examine the nexus between Asian and the US short-term financing rates and compare them between pre- and post-Asian financial crisis. Design/methodology/approach: The short-term financing rate is used in the estimation by employing two-stage cointegration test. Findings: The result of the empirical study shows several outcomes; the short-term financing rates among the selected Asian countries are not highly correlated during pre-crisis period, but the rates become strongly associated during the post-crisis period. The US financing rate has significant influence on the Asian rate during both periods. Asian financing rates are not integrated by the influence of the USA, rather regional cooperation and financial initiatives lead the regional financing rate to be integrated. Originality/value: The empirical finding of the study offers significant policy implications for strengthening regional economic bonding and developing the financial systems. [ABSTRACT FROM AUTHOR]

Background: Firearm-related death rates and years of potential life lost (YPLL) vary widely between population subgroups and states. However, changes or inflections in temporal trends within subgroups and states are not fully documented. We assessed temporal patterns and inflections in the rates of firearm deaths and %YPLL due to firearms for overall and by sex, age, race/ethnicity, intent, and states in the United States between 1999 and 2016. Methods: We extracted age-adjusted firearm mortality and YPLL rates per 100,000, and %YPLL from 1999 to 2016 by using the WONDER (Wide-ranging Online Data for Epidemiologic Research) database. We used Joinpoint Regression to assess temporal trends, the inflection points, and annual percentage change (APC) from 1999 to 2016. Results: National firearm mortality rates were 10.3 and 11.8 per 100,000 in 1999 and 2016, with two distinct segments; a plateau until 2014 followed by an increase of APC = 7.2% (95% CI 3.1, 11.4). YPLL rates were from 304.7 and 338.2 in 1999 and 2016 with a steady APC increase in %YPLL of 0.65% (95% CI 0.43, 0.87) from 1999 to an inflection point in 2014, followed by a larger APC in %YPLL of 5.1% (95% CI 0.1, 10.4). The upward trend in firearm mortality and YPLL rates starting in 2014 was observed in subgroups of male, non-Hispanic blacks, Hispanic whites and for firearm assaults. The inflection points for firearm mortality and YPLL rates also varied across states. Conclusions: Within the United States, firearm mortality rates and YPLL remained constant between 1999 and 2014 and has been increasing subsequently. There was, however, an increase in firearm mortality rates in several subgroups and individual states earlier than 2014. [ABSTRACT FROM AUTHOR]

Purpose: Despite advances in biologic therapy, approximately 10–15% of ulcerative colitis (UC) patients require surgery. We aimed to (1) examine the rates of emergent colectomy and elective ileal pouch anal anastomosis (IPAA) over time among UC patients in the USA and (2) investigate disparities in surgery rates by patient demographics. Methods: Data from the Nationwide Inpatient Sample (NIS) from 2000 to 2014 were analyzed. Inclusion criteria were admissions with a primary UC ICD-9-CM diagnosis code and age > 18. Emergent cases were defined as those admitted through the emergency room with an outcome ICD-9-CM code for subtotal colectomy. Elective IPAA cases were defined with an outcome ICD-9-CM code for IPAA, used as a surrogate measure of colectomy. Patient and hospital-level demographics were analyzed. Temporal trends of colectomy were analyzed utilizing joinpoint-regression analysis with calculation of annual percentage change (APC). Results: A total of 470,708 admissions were included over the 14-year period. Emergent colectomy rate significantly declined (APC − 7.35%, p = 0.0002), while the rate of elective IPAA remained stable (APC − 0.21%, p = 0.8). Emergent colectomy rates declined similarly across all demographics, though not as marked among patients age 50 and older and Medicare patients. Elective IPAA rates were significantly lower among blacks and patients with public insurance. Conclusions: There has been a significant decline in emergent UC colectomy rates in the USA; however, the overall need for surgery appears unchanged given stable IPAA rates. This suggests a limited impact on overall surgery rates with a shift from emergent to elective procedures. [ABSTRACT FROM AUTHOR]

The relationships between selected upper airway-related symptoms (speech disturbances, voice disorders, cough, and breathing abnormalities) and mental illness and sleep disorders have been previously demonstrated. However, these relationships have not been compared in a single study with consideration of potential confounding variables. The current research incorporates a descriptive study design of medical claims data for employees (~21,362 per year 2017-2021) with corporate insurance to evaluate the strength of these relationships, adjusting for demographic variables and other important confounders. The upper airway-related symptoms are each significantly and positively associated with several mental illnesses and sleep disorders, after adjusting for demographic and other potential confounders. The rate of any mental illness is 138% (95% CI 93-195%) higher for speech disturbances, 55% (95% CI 28-88%) higher for voice disorders, 28% (95% CI 22-34%) higher for cough, and 58% (95% CI 50-66%) higher for breathing abnormalities, after adjustment for the confounding variables. Confounding had significant effects on the rate ratios involving cough and breathing abnormalities. The rate of any sleep disorder is 78% (95% CI 34-136%) higher for speech disturbances, 52% (95% CI 21-89%) higher for voice disorders, 34% (95% CI 27-41%) higher for cough, and 172% (95% CI 161-184%) higher for breathing abnormalities, after adjustment for the confounding variables. Confounding had significant effects on each of the upper airway-related symptoms. Rates of mental illness and sleep disorders are positively associated with the number of claims filed for each of the upper airway-related symptoms. The comorbid nature of these conditions should guide clinicians in providing more effective treatment plans that ultimately yield the best outcome for patients.

Purpose: We investigated the association between county-level trends in opioid prescribing rates, a proxy for opioid misuse, and rates of reported gonorrhea (GC) among males in the United States.Methods: We used linear mixed-model regression analyses to evaluate the association between county-level trends in opioid prescribing rates and rates of reported GC among males during 2010-2015.Results: There was a positive association between trends in county-level opioid prescribing rates and rates of GC among males (β = 0.068, 95% confidence interval [CI] = 0.030, 0.105) during 2010-2015. However, the magnitude of this association decreased significantly over time in counties where opioid prescribing rates decreased (β = -0.018, 95% CI = -0.030, -0.006) and remained stable (β = -0.020, 95% CI = -0.038, -0.002) but was unchanged in counties where opioid prescribing rates increased (β = -0.029, 95% CI = -0.058, 0.001).Conclusions: During 2010-2015, we found a positive association between increases in county-level opioid prescribing rates, a proxy for opioid misuse, and rates of reported GC among males especially in counties most affected by the opioid crisis. Integrating sexual health with opioid misuse interventions might be beneficial in addressing the GC burden in the United States. [ABSTRACT FROM AUTHOR]

Testosterone supplementation has been widely used in those infected with human immunodeficiency virus (HIV) for hypogonadism, and wasting. But with effective antiretroviral therapy and increasing recognition of atherosclerotic disease and adults infected with HIV, the risks of inappropriate testosterone use in HIV-infected patients are far better recognized than previously. Testosterone use has expanded among U.S. males, but few studies have examined prescribing in those infected with HIV. In a national cohort of males with at least one outpatient prescription in the Veterans Health Administration (VHA), we examined 9475 HIV-infected males, including 2484 who had received testosterone and a randomly selected 6991 who had not. For comparison, we identified 1,387,241 uninfected males (189,369 had received testosterone and a randomly selected 1,197,872 had not). We determined rates of new and prevalent testosterone use, and also examined the adequacy of the diagnostic evaluation that had preceded testosterone initiation among our HIV-infected and uninfected testosterone groups. Our main results were as follows. HIV-infected men had higher rates of initiation (0.8% vs. 0.4% in FY09; p < 0.001) and prevalence of testosterone use (2.2% vs. 0.8% in FY08; p < 0.001) compared to the uninfected men across the entire period. Trends of prescribing for both groups followed a similar pattern, rising from FY08, reaching a peak in FY13, and then dipping in FY 14. Only 1.1% of HIV-infected patients had a fully guideline-concordant workup before starting testosterone therapy, compared to 3.5% of uninfected patients (p < 0.001). In conclusion, testosterone use among HIV-infected patients in the VHA system rose to a peak in FY13 and has decreased somewhat since. Only a small minority of HIV-infected patients who receive testosterone therapy from VHA have undergone an appropriate workup before starting therapy, suggesting an opportunity for improvement. [ABSTRACT FROM AUTHOR]

The objective of this study was to compare military suicide rates with civilian suicide rates, adjusting for age and sex differences that exist between the two populations. The number of active component (AC) service members whose manner of death was certified as suicide was determined for specific age and sex groups for each year from 2005 to 2014. Indirect standardization was then used to determine the expected number of suicides for each age/sex group, based on the U.S. suicide rates for the corresponding age/sex groups obtained from the Centers for Disease Control and Prevention's Web-based Injury Statistics Query and Reporting System. Although suicide rates among U.S. active duty Service Members were found to increase between 2005 and 2009, overall age- and sex-adjusted AC suicide rates were lower than or comparable to civilian rates every year of the study period. When suicide numbers were analyzed within specific age and sex categories, there was a significant association between higher suicide incidence and AC military status for 17-29-yr-old females in 2010, 2012, and 2014, and a significant association between lower suicide incidence and AC military status for 25-49 -yr-old males in some years. [ABSTRACT FROM AUTHOR]

Context: Segregation has been linked to unequal life chances. Individuals from marginalized communities experience more crime, higher levels of poverty, poorer health, and less civic engagement. In addition, segregated metropolitan regions have been found to display inequality in access to basic services. This article builds on these findings by linking segregation to infection and deaths from COVID-19., Methods: Using census data matched to COVID infection and death statistics at the county level, this article offers a theoretical basis for the researchers' choice of segregation measures and predictions for different racial groups. It analyzes the relationship between two dimensions of segregation-racial isolation and racial unevenness-and COVID outcomes for different racial and ethnic groups., Findings: In counties where Black and Latino residents lived in more racially isolated neighborhoods, they were much more likely to contract COVID-19. This pattern was exacerbated in counties with a high proportion of frontline workers. In addition, racial segregation increased COVID-19 death rates for Black, Latino, and white residents., Conclusions: These findings suggest that devastating outcomes of the coronavirus pandemic were linked to a long history of racial marginalization and entrenched discrimination produced by structural inequalities embedded in our geographies. This knowledge should be used to inform public health planning., (Copyright © 2023 by Duke University Press.)

Treatments for pulmonary embolism are numerous and often complex. Current data on surgical thrombectomy are important but are not readily available. We studied the National Inpatient Sample to evaluate trends in the performance rates and outcomes of surgical thrombectomy in the United States from 2003 through 2014. We think that our findings have meaningful application to the triage and risk stratification of patients who have hemodynamically significant pulmonary embolism. [ABSTRACT FROM AUTHOR]

By 1970, regulation of railroads under the Interstate Commerce Act of 1887 had resulted in an industry that was in financial ruin and unresponsive to changes in the marketplace. Subsequent legislation, which culminated in the Staggers Rail Act of 1980, was intended to resurrect the industry and did so. A Congressionally-mandated National Academy of Sciences study examined trends in the industry and the current regulatory regime and offered a number of recommendations, arguing that modernization can yield substantial benefits by modernizing what has become an outdated and ineffective system. This paper summaries some of the main findings of that study. [ABSTRACT FROM AUTHOR]

It is estimated that at least $1 trillion will be required over the next 25 years to maintain the current level of water service in the United States. A pay-as-you-go approach is expected to allow water utilities to pay for these expenses using water price increases. These price increases encourage water conservation, decreasing overall water demand. Financial forecasts that fail to consider this effect will therefore overstate anticipated system revenues and potentially lead to realized shortfalls. Therefore, understanding changes in water demand is crucial for accurate price forecasting. This article combines simple relationships that are relevant to water supply services to develop an implicit model of time-dependent system revenues, water prices, and water demand. The implicit model provides a theoretical basis for water rate-setting to generate financially sustainable water utility revenues. Results suggest that a comprehensive physical infrastructure model is critical for precision and accuracy in model forecasts. [ABSTRACT FROM AUTHOR]

To inform public health efforts to prevent epilepsy-related deaths, we used the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (WONDER; Wonder.cdc.gov ) to examine any-listed epilepsy deaths for the period 2005–2014 by age groups (≤ 24, 25–44, 45–64, 65–84, ≥ 85 years), sex, and race/ethnicity (non-Hispanic White, non-Hispanic African American, Hispanic, Asian/Pacific Islander, or American Indian/Alaska Native). Epilepsy deaths were defined by the International Classification of Diseases , Tenth Revision (ICD-10) codes G40.0–G40.9. The total number of deaths per year with epilepsy as any listed cause ranged from 1760 in 2005 to 2962 in 2014. Epilepsy was listed as the underlying cause of death for about 54% of all deaths with any mention of epilepsy in 2005 and for 43% of such deaths in 2014. Age-adjusted epilepsy mortality rates (as any-listed cause of death) per 100,000 significantly increased from 0.58 in 2005 to 0.85 in 2014 (47% increase). In 2014, deaths among the non-Hispanic Black population (1.42 deaths per 100,000) were higher than among non-Hispanic White (0.86 deaths per 100,000) and Hispanic populations (0.70 deaths per 100,000). Males had a higher mortality rate than females (1.01 per 100,000 versus 0.74 per 100,000 in 2014), and those aged 85 years or older had the highest mortality among age groups. Results highlight the need for heightened action to prevent and monitor epilepsy-associated mortality. [ABSTRACT FROM AUTHOR]

Background: Kidney transplant improves reproductive function in women with end-stage kidney disease. Little is known about contraceptive use in women with history of kidney transplants., Methods: Using data from the United States Renal Data System, we evaluated for each calendar year women with kidney transplantation between 1/1/2005 and 12/31/2013 who were aged 15-44 years with Medicare as the primary payer and linked data from the United Network for Organ Sharing, for up to three entire years after the date of transplantation. We determined rates of contraceptive use and used multivariable logistic regression to identify factors associated with contraceptive use., Results: The study cohort included 13,150 women and represented 26,624 person-years. The rate of contraceptive use was 9.5%. Compared to women aged 15-24 years, contraceptive use was lower in women aged 30-34 years (OR 0.67; CI 0.58-0.78), 35-39 years (OR 0.36; CI 0.31-0.43), and 40-44 years (OR 0.23; CI 0.19-0.28). Compared to white women, contraceptive use was higher both in black women (OR 1.26; CI 1.10-1.43) and Native American women (OR 1.52; CI 1.02-2.26). Women had lower rates of contraceptive use in the second-year post-transplant (OR 0.87; CI 0.79-0.94) and the third-year post-transplant (OR0.69; CI 0.62-0.76) than in the first-year post-transplant. Women with a history of diabetes had a lower likelihood of contraceptive use (OR 0.80; CI 0.65-0.99)., Conclusion: Among women with kidney transplants, contraceptive use remains low at 9.5%. Factors associated with a higher likelihood of contraceptive use include younger age and black and Native American race/ethnicity; and second- and third-year post-transplant. The history of diabetes is associated with a lower likelihood of contraceptive use. The study highlights the need of increasing awareness for safe and effective contraceptive use in women with kidney transplants., (© 2021. The Author(s).)

Background: Pregnancy in women with ESKD undergoing dialysis is uncommon due to impaired fertility. Data on pregnancy in women on dialysis in the United States is scarce., Methods: We evaluated a retrospective cohort of 47,555 women aged 15-44 years on dialysis between January 1, 2005 and December 31, 2013 using data from the United States Renal Data System with Medicare as primary payer. We calculated pregnancy rates and identified factors associated with pregnancy., Results: In 47,555 women on dialysis, 2352 pregnancies were identified. Pregnancy rate was 17.8 per thousand person years (PTPY) with the highest rate in women aged 20-24 (40.9 PTPY). In the adjusted time-to-event analysis, a higher likelihood of pregnancy was seen in Native American (HR, 1.77; 95% CI, 1.33 to 2.36), Hispanic (HR, 1.51; 95% CI, 1.32 to 1.73), and black (HR, 1.33; 95% CI, 1.18 to 1.49) women than in white women. A higher rate of pregnancy was seen in women with ESKD due to malignancy (HR, 1.64; 95% CI, 1.27 to 2.12), GN (HR, 1.38; 95% CI, 1.21 to 1.58), hypertension (HR, 1.32; 95% CI, 1.16 to 1.51), and secondary GN/vasculitis (HR, 1.18; 95% CI, 1.02 to 1.37) than ESKD due to diabetes. A lower likelihood of pregnancy was seen among women on peritoneal dialysis than on hemodialysis (HR, 0.47; 95% CI, 0.41 to 0.55)., Conclusions: The pregnancy rate is higher in women on dialysis than previous reports indicate. A higher likelihood of pregnancy was associated with race/ethnicity, ESKD cause, and dialysis modality., (Copyright © 2019 by the American Society of Nephrology.)

Purpose Left ventricular assist devices (LVADs) have emerged as an important therapy for advanced heart failure, with an increasing number of patients receiving these devices worldwide. However, recurrent hospitalizations among LVAD recipients lead to a significant resource burden on health care systems. In this study we evaluated the rate of hospitalizations of LVAD patients in the United States (US) and the change in this rate over the last decade. Methods We utilized a large, retrospective administrative claims dataset (OPTUM),that contains health care claims of 60 million people in the US. Using ICD and CPT codes, we identified patients on durable LVAD support between the years 2008 and 2016, and evaluated hospitalization rates of these patients. Results A total of 3082 LVAD patients were included in this analysis (76% males, mean age 57.6 ± 14 years). Overall, 16% patients had at least one hospital admission at 1 month post implant, 91% patients were hospitalized at least once during the first year after implant and 98% of the patients were hospitalized at least once during the first 2 years post implant (figure A). The mean rate of hospitalization per patient year was 1.13. During the years 2008 to 2016 the rate of hospitalizations remained stable (Figure B). Conclusion The hospitalization rate among LVAD recipients remains high, with no significant change in this rate over the last decade despite advances in technology. [ABSTRACT FROM AUTHOR]

Objective: To compare suicide rates and characteristics in East Asian and Western countries., Method: Data from five East Asian jurisdictions and five English-speaking Western countries were obtained from national offices responsible for collection of statistics. Data were graphed to demonstrate differences between East Asian and Western age patterns of suicide. Relevant literature was reviewed, including observations concerning suicide rates in various non-English-speaking European countries., Results: Age patterns and rates of suicide differ between East and West and across time, but with Japan's and the United States patterns progressively becoming more similar., Conclusions: Sociocultural factors affect suicide patterns and rates; choice of method and cohort effects affect rates. Strategies for prevention of suicide should give attention to culture-related precipitants of suicide., (Crown Copyright © 2018. Published by Elsevier B.V. All rights reserved.)